Part I of this book studies the strains on the altruistic organ and tissue donation model in the United States. This section examines organ supply and demand by critiquing what “altruistic” organ donation has come to mean in terms of social perception. Part I scrutinizes the use of “The Gift of Life” marketing concept, arguing that it is far too attenuated to promote broad-scale participant confidence. Highlighted in this portion of the book are two separate studies involving African Americans. The first of the two studies examined African Americans’ perceptions about organ transplantation more generally, including incentives versus compulsory and voluntary procurement strategies. The second study asked a diverse cross-section of African Americans about their willingness to participate in different transplant regimes. Part I highlights perceptions from study participants who shared deep-rooted concerns and fears about organ donation as we currently know it.